利多卡因、阿托品逆行膀胱注射在全麻后导尿管源性膀胱不适中的应用  

Application of retrograde bladder injection of lidocaine and atropine in catheter-related bladder discomfort after general anesthesia

作　　者：彭庶伟 赖烈勇 PENG Shuwei;LAI Lieyong(Department of Anesthesiology Shanghai Hospital of Wanzhou District,Chongqing 404020,China)

机构地区：[1]重庆市万州区上海医院麻醉科,重庆404020

出　　处：《中国医药科学》2020年第14期116-119,共4页China Medicine And Pharmacy

摘　　要：目的 探讨利多卡因联合阿托品逆行膀胱注射在全麻后导尿管源性膀胱不适中的应用价值.方法 选择2019年1月-2020年2月本院收治的在全身麻醉气管插管下实施手术患者80例为研究对象,按照随机数字表法分为两组,各40例.观察组在麻醉苏醒前30min通过20mL注射器,给予2%利多卡因20mL与阿托品1mg混合液逆行导尿管注射灌注,对照组则使用20mL生理盐水空白液逆行灌注.比较两组麻醉苏醒情况;比较两组麻醉复苏期间不良反应;比较两组导尿管相关膀胱刺激征严重程度分级;术后随访24h,比较患者膀胱功能指标变化情况.结果 观察组复苏使用呼吸机时间、拔管时间及复苏室总停留时间均显著少于对照组(P<0.05),观察组出现躁动、寒颤及心动过速的比例均明显低于对照组(P<0.05),观察组无导尿管相关膀胱刺激征比例显著高于对照组(P<0.05),且中度及重度导尿管相关膀胱刺激征比例显著低于对照组(P<0.05),术后24h,观察组膀胱功能中最大尿流量、最大逼尿肌压力及最大尿道压水平均显著高于对照组(P<0.05).结论 针对导尿管源性膀胱不适,使用利多卡因联合阿托品逆行膀胱灌注,能有效的促进麻醉复苏质量,减少麻醉相关并发症,尤其是降低膀胱刺激症状,改善膀胱功能.Objective To explore the application value of retrograde bladder injection of lidocaine and atropine in catheter-related bladder discomfort(CRBD)after general anesthesia. Methods A total of 80 patients undergoing surgery under general anesthesia and endotracheal intubation in our hospital from January 2019 to February 2020 were selected as research subjects.They were divided into two groups according to the random number table method,with 40 cases in each group.The observation group received a retrograde catheter infusion of 2% lidocaine 20 mL and 2% atropine 1 mg mixed solution through a 20 mL syringe 30 minutes before anesthesia recovery.The control group was given retrograde infusion with 20 mL saline blank solution.The anesthesia recovery,the adverse reactions during anesthesia recovery and the severity levels of catheter-related bladder irritation signs were compared between the two groups;The changes in the bladder function indexes during 24-hour follow-up after surgery were compared. Results The time of resuscitation using ventilator,extubation time and total stay time in the resuscitation room of the observation group was significantly less than that of the control group(P < 0.05).The proportion of agitation,chills and tachycardia in the observation group was significantly lower than that in the control group(P < 0.05).The proportion of catheter-related bladder irritation in the observation group was significantly lower than that in the control group(P < 0.05),and the proportion of moderate and severe catheter-related bladder irritation was significantly lower than that in the control group(P < 0.05).At 24 hours after surgery,the maximum urine flow,maximum detrusor pressure,and maximum urethral pressure in the bladder function of the observation group were significantly higher than those of the control group(P < 0.05). Conclusion For CRBD,the use of lidocaine combined with atropine retrograde bladder infusion can effectively promote the quality of anesthesia recovery,reduce anesthesia-related complication

关 键 词：利多卡因 阿托品 逆行膀胱注射 全身麻醉 导尿管源性膀胱不适 

分 类 号：R614[医药卫生—麻醉学]